An assessment by the Statin Muscle Safety Task Force: 2014 update

► Differential diagnosis of myalgia occurring during statin therapy.
► Nosology for statin-associated muscle adverse events that provides definitions with clinical utility.
► Myalgia clinical index score.
► Recommendations for neuromuscular testing.

The National Lipid Association's Muscle Safety Expert Panel was charged with the duty of examining the definitions for statin-associated muscle adverse events, development of a clinical index to assess myalgia, and the use of diagnostic neuromuscular studies to investigate muscle adverse events. We provide guidance as to when a patient should be considered for referral to neuromuscular specialists and indications for the performance of a skeletal muscle biopsy. Based on this review of evidence, we developed an algorithm for the evaluation and treatment of patients who may be intolerant to statins as the result of adverse muscle events. The panel was composed of clinical cardiologists, clinical lipidologists, an exercise physiologist, and a neuromuscular specialist.